Depression is one of the most common mental health problems in the US. According to a national survey of more than 36,000 people, about one in five Americans will experience an episode of major depression at some point in their lives. In addition, there is a high correlation between depression and substance use disorders. One study found that among people with lifetime major depression, more than 16 percent had an alcohol use disorder and 18 percent had a drug use disorder. This reflects more than twice the prevalence of substance use disorders than in the general population. Since depression and substance use feed off of each other, it’s crucial to treat them both simultaneously. So if you’ve received treatment for a substance use issue, you may have received treatment for depression as well.
Unfortunately, depression, like substance use, has a nasty habit of returning. If you’ve had an episode of major depression, there is about a 50 percent chance you will have another. And if you’ve had two episodes, your chances of another episode go up to 80 percent. Recurring episodes of depression are extremely difficult, not to mention that they are also a risk factor in relapsing to substance use. Therefore, it’s better to avoid recurring episodes of depression if possible. Here are some tips to keep depression from returning.
If you’re already seeing a therapist regularly, great! However, people often make it through a depressive episode without even being aware of what they were experiencing. Other times, people feel like they’ve already weathered the storm so there’s no point in getting help now. If you have experienced an episode of major depression, or you feel like you might be currently, it’s a good idea to talk to a therapist. This is especially true for those who struggle with substance use disorders and addiction. Although an episode may abate on its own, just getting through it doesn’t do much to help you avoid the next one. A therapist can help you sort out the issues that caused your first episode and teach you some coping tools to help keep depression at bay.
If you did get professional help for your first–or subsequent–episode of depression, it’s important to keep up with your treatment plan. Consider committing to ongoing therapy, especially if you have experienced multiple episodes of depression. If medication is part of your treatment plan, take it consistently and according to your doctor’s orders. Often, people stop taking their medication once they start feeling better. Unfortunately, this tends to lead to them feeling worse again soon. You won’t necessarily have to be on antidepressants forever. However, it’s a decision you should discuss with your therapist. Above all, keep in mind that depression is typically a chronic condition. Many of the risk factors, such as childhood abuse or neglect, high trait neuroticism, and genetic predisposition never go away. Keeping depression under control may be something you will need to consider and maintain long-term.
Although the factors noted above can make you more prone to depression, the first episode and subsequent episodes are typically triggered by specific events. Often, such events are stressful or life-changing, such as a breakup or divorce, losing a job, or the death of a loved one. Sometimes even positive events can be stressful, such as getting married or getting promoted.
For women, menstruation, pregnancy, childbirth, and menopause cause massive hormonal changes that have been linked to depression. Even new fathers may experience postpartum depression as a result of increased responsibility and decreased sleep.
Seasonal changes are another common trigger of depressive symptoms. The most problematic time of year is typically late fall or winter since the days are short and cold. However, some people are also triggered by spring weather.
Unfortunately, there is often little you can do to avoid triggers. Unless you have homes in both hemispheres, you can hardly avoid the seasons, and we already do what we can to avoid major life disruptions like losing a job or a loved one. The important thing is to be aware of triggers and how to cope with them. You may decide to devote extra time to therapy or self-care to help put your learned coping mechanisms into practice.
Regular exercise is one of the best things you can do for your mental health. It reduces stress, improves your executive functioning, and increases mood-lifting endorphins. One large study found that people who exercised reported 43 percent fewer days of poor mental health in the past month compared to people who didn’t exercise. Most studies have found that moderately intense aerobic exercise has the best effects on mental health. Additionally, research shows that exercise involving a social aspect, such as team sports, had the greatest effect.
If exercise isn’t the single best thing you can do for your mental health, then surely sleep is. A chronic sleep deficit–which may develop in as little as a week–causes significant cognitive impairments and increases your risk of poor mental health. One study followed a group of 1000 adults for three years. The study found that those who reported insomnia at the beginning of the study were four times more likely to have an episode of major depression. Getting a solid eight hours of sleep each night is one of the best ways to protect against depression.
Finally, protect yourself against recurring episodes of depression by building a support system. Practice nourishing relationships by connecting regularly with friends, family, sober friends, support groups, and/or medical professionals. Feeling socially connected reduces stress because you know you have the resources to deal with whatever happens. Simply knowing that you’re not alone can go a long way to protect you against future episodes of depression.
If you’ve had one episode of major depression, it’s a coin toss as to whether or not you will have another. Since your mental health and your sobriety are interdependent, staying sober may depend on your ability to avoid or cope with a recurrent episode of depression. At Steps Recovery Centers, we know that overcoming addiction is a complex process, one that is different for everyone. We want to give our clients whatever they need to live lives free from addiction to drugs and/or alcohol. To learn more about our alumni services, call us at 385-236-0931.